14 months after closed rhino my nose is irregular/ugly. What can I do for improvement? I'm thinking secondary open (Photo)
1 year ago
hello,i m not happy since i had done my nose,I had hump removal and cartilage resection, i get carilage spreader graft,i had medially and laterally mild osteotomy,septum subluxation by 3 mm rescetion, and my tip turned up,non of the procedures actually suits my face.my nosebone feels depressed, in fragments,and my nose too short made my upper lip longer,can i remove spreader?as my nose too wide,?or can i augment some hight back?what can i do with my wide broad after i had alredy osteotomy?thanks
Doctor Answers 2
Many of us prefer an open approach to Rhinoplasty in revision cases. Although some advocate placement of spreader grafts through a closed approach, I do not see any advantage to this. Spreader grafts can be very useful in situations of a curved dorsal septum, or nasal obstruction related to internal nasal valve narrowing, but aren't routinely used in primary Rhinoplasty. I agree that your nose appears more wide and the left nasal bone appears depressed. These are issue which could be addressed with a properly performed revision. The critical part is choosing the right Surgeon who can choose the best approach in his/her hands.
The nose is too wide in the area of the middle vault, the spreader grafts have to be removed and sculptured thinner and probably the osteotomies left some irregularities, so they have to be done again in lower position. The secondary rhinoplasty needs cartilaginous grafts harvested from auricular concha: they are useful to reshape the dorsum in a more natural way and hide irregularities. The broad tip can be narrowed by using sutures and an only graft will give more definition. Regarding the projection and the rotation of the tip it should be necessary to examine pictures on the profile in order to analyse the length of the nose too and find solutions. During the secondary rhinoplasty any previous procedures can be repeated without problems in order to improve their effects. I think that in this case a good result can be obtained.
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